BLD2022-0583_Application_5.6.2022_3.45.05_PM_2853998CITY OF EDMONDS M BuildingPermit.com
Plumbing Application #1138624 - Willis, Derek
Applicant
First Name Last Name Company Name
Aujerae Edwards Pacific Bath Company
Number Street Apartment or Suite Number E-mail Address
17780 ne airport way 17780 NE permits@speconnw.com
City State Zip Phone Number Extension
PORTLAND OR 97230 2065652035
Contractor
Company Name
PACIFIC BATH COMPANY
Number Street Apartment or Suite Number
17780 NE AIRPORT WAY
City State Zip Phone Number Extension
PORTLAND OR 97230 2065652035 (206)565-2030
State License Number License Expiration Date UBI # E-mail Address
SPECICN793OZ 8/31/2023 FD357F144 permits@speconnw.com
Project Location
Number Street Floor Number Suite or Room Number
1133 SIERRA PL
City Zip Code County Parcel Number
EDMONDS 98020 00548900002204
Associated Building Permit Number Tenant Name
26259 Willis, Derek
Additional Information (i.e. equipment location or special instructions)_
Work Location
Property Owner
First Name Last Name or Company Name
Derek & Rebekah Willis
Number Street Apartment or Suite Number
1133 SIERRA PL
City State Zip
EDMONDS WA 98020
Certification Statement - The applicant states:
I certify that I am the owner of this property or the owner's authorized agent. If acting as an authorized agent, I further certify that I have full power and
authority to file this application and to perform, on behalf of the owner, all acts required to enable the jurisdiction to process and review such application. I
have furnished true and correct information. I will comply with all provisions of law and ordinance governing this type of application. If the scope of work
requires a licensed contractor to perform the work, the information will be provided prior to permit issuance.
Date Submitted: 5/6/2022 Submitted By: Aujerae Edwards
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CITY OF EDMONDS MyBuildingPermit.com
Plumbing Application #1138624 - Willis, Derek
Project Contact
Company Name: Pacific Bath Company
Name: Aujerae Edwards Email: permits@speconnw.com
Address: 17780 ne airport way 17780 NE Phone #: 2065652035
AIRPORT WAY
PORTLAND OR 97230
Project Type
Single Family Residential
Activity Type
Repair or Replacement
Scope of Work
Plumbing
Project Name: Willis, Derek
Description of Work: Remove shower/tub combo install Walk in Shower using existing foot print and
plumbing
Project Details
Scope of Work
Plumbing Fixtures for Building Permit
Fixtures
Shower, Tub or Combo 1
Associated Building Permit?
There is no other onsite work that requires a building
permit.
Work Location
Work Description/Location (example: 1st floor, bathroom
Master Bath, Garage)
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